Speech Dr. Cindy Forbes Inaugural Address Dr. Cindy Forbes President Canadian Medical Association Halifax, NS August 26, 2015 Check against delivery
Good afternoon to my colleagues, to my family and to our guests. As I stand here before you today, I can't help but wonder whether every President who has served before me has looked at the landscape before them, at the horizon in the distance and wondered "Could there ever be a time of greater challenges for our profession, our health care system, and our patients?" The landscape around us is shifting professionally, technologically and socially. In terms of our profession: Our workforce is getting older and with impending retirements, our colleagues who are Generation X and Y will soon form the majority of practicing physicians. We know that getting involved in leadership early in your career is the most predictive factor of whether you ll assume leadership positions later on. We need them to be involved and we need their input now. We re being asked to be more accountable but to whom and what form should this take? We re asking ourselves what does it mean to be a medical professional in 2015? In terms of technology: Our system lags behind other industries in infrastructure and the use of electronic communication to radically improve patient care. We lack meaningful data that will help us shape our practices and improve the system. There s unprecedented access to new information, but how do we assess it all and integrate the best of it into our practices? We ve become so technologically advanced but at times are we too technologically dependent? In terms of the changes in our society, there s no better example than the discussions we re having around physician assisted dying and end-of-life care. Physicians are playing a key role in redefining how Canadians might choose to live and die. The demographic shift taking place in our country has also highlighted the need for dramatic changes in our health care system and I'm proud to say that the CMA is leading the charge to ensure that our seniors are receiving the best possible care. 1
These complex issues are neither easily defined nor easily solved. But we must deal with them, and that s why we re all here. It s when things are extremely complex, that it's so important to focus on what really matters, to return to the basics of why we practice medicine. Intuitively, we know we can best solve problems by coming together, by connecting. And that s what I want to talk about today. I don't know whether those of you who ve travelled here from other parts of Canada, or the world, have noticed but Maritimers place a high value on connections. Within a few minutes of being introduced you ll be asked "Where are you from?" or Where did you go to school? If you re from Cape Breton they might ask who s your father? And if you're here from Ontario or Alberta, they might ask you if you know their cousin who s working in Toronto or northern Alberta. From the time we re born, we seek human connections and social interaction. Our brains are wired for it our species relies on it for survival. And we place a high value on that interaction. This is something I m reminded of every day in my practice in Fall River. Often after I ve referred a patient to see a specialist, I ll see them to follow up on the consultation and review the recommendations that were made. I ll ask my patients how did you make out at your visit with Dr. Smith? Almost without exception, the first thing they ll tell me was whether they liked Dr. Smith. They ll say Oh she was really nice or I liked her but not her receptionist. And then they might eventually tell me about what she said. The connection that was formed is the most important element to them and the most likely to influence whether they trust her and will follow her advice. Often it s how we deliver a message that s more important than the message itself. As physicians we connect with our patients every day. It s through these interactions that we build trust, our most valuable clinical tool. We sometimes vastly underestimate the powerful influence that we have on our patients lives. When I look back on my 29-year career in family medicine, I can think of a few situations where my clinical judgment and experience contributed to saving the life of a patient treating an anaphylactic reaction to a bee sting, diagnosing lymphoma in a patient who thought she had the flu. Yes, as physicians that s what we re trained for. But the truth is that I've had many more opportunities to impact my patients lives through what might seem like the smallest of 2
interactions a quiet conversation, a listening ear, a phone call after hours. It s the quality of these interactions, these relationships that matter. The attitudes, values and behaviours that drive our practice are so important and strongly influence the relationship we have with our patients. This is what we re getting at when we start to talk about professionalism. This word can feel like such a mouthful, but what does it really mean? This year, we ll be asking for your help in narrowing down a definition. What are some of the challenges you face in your day-to-day work? How do they impact the way you practice? What obligations do you feel towards your patients, the public and the health care system? We hope to facilitate a discussion with members to encourage self-reflection, and to enable an honest discussion about the way we think about our own profession. In a few weeks, I ll be travelling to England to learn more about the British Medical Association's grassroots program called "Professionalism Matters". And there s already an international conversation on medical professionalism taking place on Twitter so feel free to join in and add your voice using the hashtag gooddoctors. As we move forward as a profession, we ll continue to serve our patients well by recognizing the importance of human interaction, including our ability to work effectively in teams. As humans just as we re programmed to connect with one another, we re also meant to exist in teams. For those of you wondering about the pictures behind me, you re looking at a war canoe. Staying active is a big part of my life and I ve been a war canoe paddler for many years. One thing I love about paddling is that when you re out on the water with your team, you re literally all in the same boat, navigating the same course together. Many factors can affect our team s performance the weather, our experience, our strength, our training, our commitment, but we all have the same goal: having the boat move as smoothly and quickly through the water as possible. While we do have what you might call a leader a cox who steers the boat, and a stroke who sets the pace everyone has an equally important role to play. Because the overriding principle in paddling is that the boat will only reach its maximum speed when, through teamwork, every paddle hits the water at the same time. 3
A study done at Oxford University with rowers illustrated that when they rowed as a team with exactly the same stroke rate and power, they produced higher levels of endorphins than when they performed alone in a single shell at the same intensity. So the effect of a well-functioning team is indeed better than the sum of its parts. We also have the opportunity to apply these principles of teamwork and human connections to our work at the CMA. To connect with physicians by: bringing the action closer to where we live and work, hosting events all across the country. supporting the over 600 members of our MD-MP Contact Program, who drive political change at the local level. involving our students, residents and early-career physicians in ways that are meaningful to their needs. I ll be capturing my year as President on Instagram at CMA_docs, and I hope to connect with many of you there! We re connecting with policymakers by: building on the work of Dr. Francescutti and others in highlighting the issue of palliative care in this country the great progress that s been made and the areas that still need our attention. listening to Canadians, our members and other health care professionals on the issue of assisted-dying. We ll be taking the discussions from this meeting, the direction that you ve given us, forward to the policymakers and will ensure that the voice of physicians and our patients is heard. reaching into the community to join hands with organizations that share our vision for better health and health care. And we re connecting with Canadians: My thanks to Dr. Simpson, who has advocated tirelessly for a national strategy for seniors care. Chris's use of social media to spread the word and to build public support has been amazing. As we strive to build new connections and strengthen existing ones, we can only reach our full potential with the support of our over 80,000 members behind us. 4
We re a team we re team CMA. Together, we have huge opportunities to positively influence the health of Canadians. They deserve better health care, we know it, and we will lead change. Yesterday, you heard Dr. Simpson, in his elegant words, reissue his challenge to political parties on seniors care. I m here today to tell you that I will take that message forward for Canada s doctors, and most importantly, for our patients, who are looking to us to lead on this and to hold our politician s feet to the fire. As we prepare to take on the challenges ahead, I ll leave you with the words that our paddling coach uses to let our team know to get ready because it s time to go: Paddles ready, paddles up, take it away! Thank you. 5